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Integrated Team Care for Chronic Conditions

Aim of the Service

The Integrated Team Care (ITC) program is a health program for Aboriginal and Torres Strait Islander people who are at risk of or living with chronic disease. It includes Outreach workers, Indigenous Health Project workers and a Care coordinator who are all able to work together with you to help you achieve better access to the medical care and equipment that you may need.

Your ITC team can:

  • Help you understand your chronic condition and how to manage it
  • Support you to make health care appointments, including with specialists and allied health professionals
  • Arrange transport to and from your medical appointments

Eligibility

  • Identify as an Aboriginal and/or Torres Strait Islander person
  • Have a chronic condition diagnosis, including (but not limited to) diabetes, cancer, cardiovascular disease, chronic kidney disease, chronic respiratory disease or a mental health condition
  • Have a current GP Management Plan or Team Care Arrangement (TCA) – Your GP can help you to organise these forms if needed

How to get an appointment

  • Referrals to the Care coordinator must be made through your GP
  • For referrals to the Outreach worker, please call (03) 5820 0035 

Any other locations for appointments?

  • The Outreach Worker and Care Coordinator can support you in a way that suits you best, including home visits and picking you up from your home to take you to a medical appointment
  • ITC provide service across the Hume Region, this includes;
  • Greater Shepparton
  • Moira Shire
  • Mitchell Shire
  • Strathbogie Shire
  • Murrindindi Shire 

Cost?

  • No cost
  • It does not matter which GP clinic or Aboriginal health service you attend
LINKS TO EXTERNAL SOURCES OR SUPPORT NUMBERS
  • Rumbalara Aboriginal Cooperative
    https://www.rumbalara.org.au/
  • ITC Program Activity Implementation Guidelines – Australian Government Department of Health
    Click Here
  • Australian Indigenous Health InfoNet (Resources, information, guides, reviews)
    https://healthinfonet.ecu.edu.au/
  • Koorified: Aboriginal Communication and Wellbeing Resource (Published by VACACHO & La Trobe Uniiversity. Includes information on language, country, mob, health, respect and culture)
    Click Here